临床医生道德创伤现状及影响因素分析

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[中图分类号]R-05 [文献标志码]A [文章编号]1001-8565（2025）11-1467-09

DOI：10.12026/j.issn.1001-8565.2025.11.13

Abstract： Objective： To investigate the current situation and influencing factors of moral injury among physicians in China，and to analyze the relationship between moral injury and medical professonalism， providing a reference for preventing and treating moral injury and protecting physicians’ physical and mental well-being.Methods：From September to October 2O23，the convenience sampling method was used to conduct a questionnaire survey on practicing physicians，interns，or resident physicians in hospitals at allevels in Heilongjiang Province，Guangdong Province，Xinjiang Uygur Autonomous Region，and Beijing. Results： A total of 421 practicing physicians，interns，or resident physicians were included.The total score of the Moral Injury Symptom Scale for Healthcare Professionals was （42.07±13.67） ，of which 31.6% of the respondents had significant clinical distress and functional impairment related to moral injury，with the highest mean score for the dimension“unforgiveness.” Corelation analysis revealed that the total score of medical professionalism， as well as the scores ofeach dimension，were significantly negatively corelated with the total score of the Moral Injury Symptom Scale. Linear regression analysis showed that job satisfaction，medical professionalism， whether they felt a low level of organizational support in the handling of doctor-patient disputes，whether they had witnessed patients’suffring or dying，gender，whether they had worked overtime，and whether they had needed professional help in relieving psychological stress were influencing factors of physicians’moral injury. Conclusion：The physicians’moral injury in China isat amedium level overall Physicians’moral injury is ffected by numerous factors，with a significant negative correlation between moral injury and medical professionalism. It is recommended to improve the level of organizational support in medical institutions and medical professionalism， establish specialized psychological and moral aid institutions，and create a caring organizational atmosphere，to prevent and repair physicians’moral injury and better protect their physical and mental well-being.

Keywords： moral injury；physicians；medical professionalism；well-being

0 引言

2009年，Litz等首次提出了道德创伤理论模型，并将其界定为：道德创伤（moral injury，MI）是指个体在经历了违背内心道德准则或价值观的事件后，对心理、精神、行为等方面造成了消极的影响。（剩余12093字）